Jul. 17th, 2009

tim: Tim with short hair, smiling, wearing a black jacket over a white T-shirt (Default)
Last summer I had occasion to receive some medical care at the Portland Clinic (and was misdiagnosed in a way that suggested vast incompetence on the part of the doctor I saw there, but that's an entirely different story). To this date, I've still been getting bills from them for an amount less than what my insurance company says they paid them.

Today I finally figured out why: Blue Cross (which was my insurer at the time) made several payments to the Portland Clinic towards my bill and would have made a third one, but the Portland Clinic owed them money in exchange for Blue Cross having overpaid for other patients. So in return, Blue Cross never paid them for my claim, but deducted it from the Portland Clinic's debt to Blue Cross instead (this is apparently called a "punch credit").

In multiple phone calls to the Portland Clinic, they never mentioned to me that this happened, but have continued to bill me for the amount that Blue Cross deducted as a punch credit. That's fraud, kids!

Blue Cross doesn't deserve much credit either, because it's taken about ten hours on the phone with them over a period of six months for me to finally get them to tell me what happened. But at least they aren't committing outright fraud.

Obviously, whatever state board regulates such things will hear about this once I finally get the story straightened out.

And obviously, that this ever became my problem is just one minor symptom of the raging disease that is a for-profit health care system.


tim: Tim with short hair, smiling, wearing a black jacket over a white T-shirt (Default)
Tim Chevalier

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